SHM Converge Scientific Abstract ePoster Gallery-Optimizing Discharge Before Noon for Hospital Medicine Patients: E-Huddle & Power Hour Initiatives

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This Mayo Clinic quality improvement project aimed to increase hospital medicine discharge-before-noon (DBN) rates to improve bed availability and patient throughput. A multidisciplinary team of hospitalists, nurses, social workers, case managers, pharmacists, and other staff reviewed causes of late discharges and found that many barriers were related to poor communication and limited advance planning.<br /><br />Two main interventions were introduced. First, an “Afternoon E-huddle” used a secure electronic health record chat to bring together the care team each afternoon to identify patients likely to discharge the next day, assign tasks, and coordinate discharge timing. This approach was considered easy to use and did not interrupt workflow, leading to adoption across hospital medicine units.<br /><br />Second, a “Power Hour” changed morning workflow so that patients expected to discharge were seen first, with discharge paperwork completed within the first hour of the day. The goal was to shift discharge preparation earlier and encourage teams to plan ahead rather than treat discharge as a same-day task. Posters, emails, and meetings helped promote this culture change.<br /><br />The interventions were feasible even during the COVID-19 pandemic, despite high census and staffing shortages. After implementation, DBN rates improved from 20.9% in 2019 to a peak of 28.1% in April 2021, though there was a slight decline in the final two months, likely due to very high inpatient volumes. Overall, the project showed that structured communication and workflow redesign can improve timely discharge.

Asset Subtitle

Jennifer Kleinman Sween

Meta Tag

Author List Jenna M. Jacobson, Jennifer Kleinman Sween, Megan Rensing, Ragaisis Taryn, Sagar Dugani, Trevor Coons

Category Innovations

Concept Discharge Before Noon

Concept Hospital Bed Capacity

Concept Patient Throughput

Concept Multidisciplinary Communication

Concept Discharge Rate

Distinguished Non-Finalist

Presenter Organization Mayo Clinic

Presenting Author Jennifer Kleinman Sween

Track Quality Improvement

Keywords

discharge before noon

hospital medicine

quality improvement

patient throughput

bed availability

multidisciplinary team

Afternoon E-huddle

Power Hour

workflow redesign

COVID-19 pandemic

Discharge Before Noon

Hospital Bed Capacity

Patient Throughput

Multidisciplinary Communication

Discharge Rate